Frequently Asked Questions

Q. Have you published anything on RSI?
A. Yes: “Incidence of Reflex Sympathetic Dystrophy in Repetitive Strain Injuries” was published in an online newsletter.
My treatment plan was pubslished in Dr. Pascarelli's Complete Guide to Repetitive Strain Injury.
I also wrote a chapter with reference to RSI in Ronnie Sellers’s 40 Things To Do When You Turn 40.

Q. What if I have to change careers because of RSI?
A. This occasionally happens. Especially if people miss work for a while to recover. There have been a few careers which some patients have found less painful. Several have gone back to school which can be very good if patients can get a letter from thier doctors to get assistance from the student office of disabilities. Patients have been able to get extensions for papers due so they can take more breaks when writing, proxies for exams, extended time for exams, free copies of another students notes from the class, and there have been occasions where they have had another student to help them carry books and turns pages. I have seen patients who start school with symptoms end school pain-free due to all of this assistance.

Patients frequently pursue a career in teaching—math is especially good since it does not have the same need for writing that many other classes have. There have been patients who have become security guards, tour guides, translators, & tutors. Patients teach Yoga classes or learn voice activated software and train others in how it works. A couple of patients changed positions in their companies to work in human resourses and teach orientation classes for new employees. They also organize/ create and present seminars for office staff to maintain compliance in some work environments.
This is just a sample, there are more opportunities than people realize when they first find themselves injured needing to change careers.

Q. How can I find a good therapist?
A. The first thing to do is to ask the scheduling person how often they schedule patients for each therapist. If they schedule patients every 15 or 20 minutes, after the first hour that therapist is going to have a handful of patients there all the time to watch. This will limit their ability to spend time with you alone, and RSI needs attention, so you need to find a facility which will allow you at least 20 mins of 1-1 time with your therapist. After that, the only way to find out what they know is to go for a few visits and see how you feel. If after 4-6 visits you are feeling more symptoms/worse, it may be they are not following the right protocol and actually adding to your overuse. Follow your instincts. If it doesn't feel right find another place.

Q. What have you seen as the cause of limited improvement when patients are transfered from other clinics?

The patients has been left alone for most of their treatment session either without direct supervision in a gym to do exercise or recieving a modality such as electrical stimulation or a tactile sawdust machine. There was very little interaction between the therapist and the patient with relation to re-training discussion or activity modification for patient education purposes.

The patient was using the pain as a guide, waiting until the pain started before stopping an activity.

The patient was not performing any posterior thoracic exercises as part of their routine or they were using compensatory muscles to help perform these exercises

The patient has not attmpted to structure a slow gradual reintegration protocol of previously irritating activities in any methodical form. They typically randomly attempt to increase UE use "naturally" causing flare-ups from unexpected overuse.

The patient has a mild case of reflex sympatetic dysfunction with mild burning after overuse which is not being treated pharmacologically.